Crowe talks hospital merger, Insure Tennessee


By Jeff Keeling

Rusty Crowe

Rusty Crowe

The state is likely to maintain significant oversight if Mountain States Health Alliance and Wellmont Health System are allowed to merge, and that will benefit consumers, State Sen. Rusty Crowe told a group gathered Friday for a Chamber of Commerce-sponsored legislative update.

And while it may not quite be “getting better,” Insure Tennessee isn’t ready for the charnel house just yet, Crowe (R-Johnson City) added.

Crowe said in the wake of the Mountain States-Wellmont merger announcement – or rather in the run-up to it – legislators updated the section of the 22-year-old “Hospital Cooperation Act” dealing with “Certificate of Public Advantage,” TCA 68-11-1303. A “COPA” would govern any merger through regulation and oversight designed to achieve its main end: making sure the benefits outweigh any disadvantages attributable to a reduction of competition caused by the merger.

Crowe said Tennessee’s Attorney General, Herb Slatery,  and Secretary of Health, John Dreyzehner, worked closely with the two systems to amend the act for an era when, he said, hospitals are merging more to survive than simply to grow. Regardless, Crowe said, the state’s role is to, first, elect whether to award a COPA and even allow the merger, and second, regulate it in a way that benefits patients, businesses and other community members.

“It’s not something that they just say ‘okay’ and then they leave and don’t deal with it. It’s continual supervision and continual oversight of this situation, and I think the goal is to make sure that the quality of health care and the affordability of health care, cost effectiveness and the accessibility of health care is there in a way that the benefits of this merger outweigh any disadvantages.”

Elliott Moore

Elliott Moore

Even during negotiations with Slatery and Dreyzehner, Crowe said, “many of the things that Wellmont and Mountain States thought should be there, they said, ‘no, no, no, our goal is to make sure that we all are interested in the health of the region.’ What made me proud was that both systems agreed with that and they all came together to try to benefit the health of the system.

“So I think you’re going to see a system wherein it’s controlled in such a way that the atmosphere we had before, it will be as good or better – hopefully the two can come together and forge a document that can lead us into a situation wherein health care is one of the best we’ve seen in this nation. I think we’ve set the stage for that.”

One audience member, while acknowledging that a lot of area businesses are optimistic, “for all those reasons that you gave,” added that businesses want to be, “engaged with the department of health and the (attorney general). Can you kind of explain how the law will work?”

For that, Crowe turned to Elliott Moore, Mountain States’ vice president for government relations, who was in attendance.

“It’s going to be a very open, transparent process,” Moore said. “The statute says that there shall be public hearings. There will be opportunities for business, the insurers, other provider groups, to have a voice in what the certificate of public advantage ultimately becomes.

“We’ll file the application, but it’ll be modified based on what the attorney general and the department of health hear.”

Moore said the systems will be going through the same process in Virginia to seek a COPA to govern their hospitals there.

“There will be a lot of opportunity for public input, so don’t be shy,” she added.

Insure Tennessee not dead yet

“It’s still alive,” Crowe said of Insure Tennessee, Republican Gov. Bill Haslam’s twice-failed proposal to pass a Tennessee-specific Medicaid expansion. The proposal, which is widely supported by the medical community but opposed by groups who fear its ultimate cost to state taxpayers, passed Crowe’s Senate Health and Welfare Committee on its second attempt, then died in finance.

“The governor’s going to be trying to find a way to calm the waters and convince legislators that this is the right thing to do,” Crowe said. He added that the provisions separating Insure Tennessee from the standard Medicaid expansion should be attractive to conservatives. They include accountability measures for recipients “that move folks away from an entitlement mentality,” the ability to stop the program if funding falls through, and a lockout provision of up to six months for recipients who don’t comply with program rules.

Crowe also pointed to the support from Tennessee hospitals to cover the gap when federal funding drops to less than 100 percent of the program cost after several years.

“From that perspective, it makes sense,” Crowe said. “Again, it’s the ideology and the politics of it that hurt this plan.”


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